Hsieh Yung-Kun, Lee Chien-Hui, Chen Yih-Sharng, Wu I-Hui
Cardiovascular Section, Department of Surgery, Chang-Hua Christian Hospital, Chang-Hua City, Taiwan.
Cardiovascular Section, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Asian J Surg. 2015 Jul;38(3):174-6. doi: 10.1016/j.asjsur.2013.07.010. Epub 2013 Aug 24.
Sutureless repair is an effective procedure for acute left ventricular free wall rupture; however, it may be complicated with a left ventricular pseudoaneurysm during the late postoperative period. We present a case of a large ventricular pseudoaneurysm that occurred after the sutureless repair of an inferior myocardial infarction with oozing left ventricular free wall rupture. The patient underwent aneurysmectomy successfully. Serial magnetic resonance imaging (MRI) indicated that the necrotic left ventricular wall, which was covered by Teflon felt, had ruptured and developed a pseudoaneurysm. Therefore, after simple gluing for a left ventricular free wall rupture, patients should undergo careful follow-up evaluation for potential pseudoaneurysm. Moreover, early detection by MRI and prompt surgical repair of the complication are important in patients with left ventricular free wall rupture.
无缝合修复是治疗急性左心室游离壁破裂的有效方法;然而,术后晚期可能并发左心室假性动脉瘤。我们报告一例大型心室假性动脉瘤病例,该病例发生在因左心室游离壁破裂渗血而行下壁心肌梗死无缝合修复术后。患者成功接受了动脉瘤切除术。连续磁共振成像(MRI)显示,被特氟龙毡覆盖的坏死左心室壁破裂并形成了假性动脉瘤。因此,在对左心室游离壁破裂进行简单粘合后,患者应接受仔细的随访评估,以排查潜在的假性动脉瘤。此外,对于左心室游离壁破裂患者,通过MRI早期发现并及时手术修复并发症非常重要。